Coding Quality Assurance Specialist III

Job Duties & Responsibilities

• Assigns ICD-10-CM, ICD-10-PCS, and DRG codes to hospital inpatient records.
• Reviews and interprets physician documentation to appropriately assign diagnosis and procedure codes.
• Communicates with and provides feedback to the education team and/or providers.
• Reviews patient charges to determine necessary coding to complete the account.
• Identifies principle and secondary diagnoses and procedure codes from the electronic medical record.
• Utilizes the encoder or coding books to generate ICD-10-CM, ICD-10-PCS, and DRG codes for diagnosis and procedures.
• Sequences diagnosis and procedures to generate appropriate billing.
• Utilizes other available resources for assignment of codes as necessary (e.g., Epic, MIQS, Cardio IMS, and coding reference materials).
• Affords assistance to other coders in resolving coding problems.
• Completes abstracts for records as appropriate.
• Affords assistance in correction of problem accounts.
• Reviews charts for completeness.
• Participates in education and maintains certification.
• Affords assistance in auditing records.
• Maintains concurrent coding for inpatient records.

Skills & Requirements

• High School Diploma or equivalent.
• One of the following Licenses/Certifications: CCA, CCS, CCS-P, CIPC, COC, CPC, CRC, RHIA, RHIT.
• 4 years coding experience with preferred experience using an encoder and experience using an electronic medical record.
• Experience with Inpatient Hospital coding highly desired.
• Strongly desired RHIT/RHIA & CCS certifications.

About Us

Texas Children’s has been leading the charge in patient care, education, and research since 1954. Our comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties, the Jan and Dan Duncan Neurological Research Institute (NRI), the Feigin Tower for pediatric research, Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births, Texas Children’s Hospital West Campus, a community hospital in suburban West Houston, Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston, and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children’s Health Plan, the nation’s first HMO focused on children; Texas Children’s Pediatrics, the largest pediatric primary care network in the country; Texas Children’s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse, and successful pediatric programs in the nation.